Healthcare Provider Details

I. General information

NPI: 1568436517
Provider Name (Legal Business Name): STUART H FREEDENFELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 08/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 S MAIN ST STE A
STOCKTON NJ
08559
US

IV. Provider business mailing address

56 S MAIN ST STE A
STOCKTON NJ
08559
US

V. Phone/Fax

Practice location:
  • Phone: 609-397-8585
  • Fax: 609-397-1907
Mailing address:
  • Phone: 609-397-8585
  • Fax: 609-397-1907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STUART H FREEDENFELD
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 609-397-8585